Is labour always quicker second time round?

[bluebear]

I've heard that, usually, second labours are faster than first, but does anyone know if this is true for births after an emergency c-section. I had a c-section after fully dilating (took best part of 2 days to go from 2cm to 10cm) and then giving baby 4 hours in which to make his appearance.
If there is a second time for me I was hoping that it would be quicker but one of my friends recently disagreed because I 'didn't actually have the baby'.
Anyone know the answer, or anyone had a speedy VBAC?

I don't know because haven't got to second baby yet but believe that it's not that simple if you have had a caesarean before and the possibility of another is greater. I know that it's supposed to be quicker next time around for vaginal deliveries but again, each labour is different so I guess it depends.

I pretty sure that the reason it is quicker second time around is that everything has already been stretched once. So, sorry to disappoint you but if you have a VBAC it is probably pretty like a first birth from that point of view.

Hopefully Leese or Mears (both midwives) can tell you.... I don't think that your 2nd labour would necessarily take 2 days to get you THAT dilated but I am no expert.

Bluebear,

On the whole second labours do tend to be faster but not all. Because you got to full dilatation last time it will count as a second labour this time. For women having a labour after a first delivery by C/S without the cervix dilating - that would be classed like a first labour.

The pushing part would be expected to last like a first baby because the muscles have not been stretched like with a previous vaginal delivery. Maybe that was what your friend was thinking.

I have delivered a few women who were emergency C/S first time and were actually admitted in advanced labour second time and had vaginal deliveries. It is much better to go into labour naturally after a previous C/S when your body is ready to do it.

Hope that makes sense !!

Have to agree with Mears on all points. In light of full dilatation last time, the liklihood is that you will progress quickly to full dilatation this time (although there are exceptions to the rule!). Ladies who have had babies vaginally before can also be very quick in the second stage, but as Mears points out, this would be like first time around for you, and pushing could take on average one to two hours.
Interested to read you took two days to go from 2cm to 10cm - I guess the large part of this time was taken up dilating to 3cm (the 0cm to 3cm bit is not always classed as 'labour' as such, more 'early labour', and can take an age). From 3cm onwards, it could be presumed that you should dilate at around 1cm per hour with a first baby - some women will be faster, others slower - but not 48hrs slower!
Hope things go swimmingly for you this time bluebear. Bet you'll be amazed at the difference!

Mears and Leese, thank you!
Leese - yes you're right, the majority of the time was from 2cm to 3cm (most of the time I was at home, quite happy but had to go to hospital once waters went) but I still took 17 hours to go from 3cm to 10. I had been told the 1 cm an hour reckoning so everytime I had an internal I was very disappointed!
Strangely enough the hospital policy would normally be to go all out (syntocin (?) drips etc) to speed up such slow progress but baby's heart trace was steady, and there was a major lack of staff (or too many proper emergencies) so I was left to get on with it. I was able to cope with the pain but I was very tired and was worried that I wouldn't have enough energy to push.
In the end the midwives discovered that although the baby's body was in the correct position his head was looking over his shoulder and he hadn't even engaged properly. As there was a queue for the operating theatre (lots of emergency sections that night) I was able to give him 4 hours to turn but he didn't.
End result was a healthy baby, and that's the important thing

I've never had a c/section, but my labours have all been progressively quicker, and they were all precipitous labours too (under 3 hours). In case you are interested here is how they went. Number 1 was 2 hours 20 mins, number 2 was 1 hour 50, number 3 1 hour 11, and number 4 was 22mins. So i guess i prove your theory!

Leese and/or Mears (and/or anyone else), could I please ask a similar question at your on-line advice surgery? Bluebear, all the best, plenty of practising to get done now.

My question is sort of the reverse of bluebear's as I had a speeded up delivery last time and was wondering what to prepare myself for this time. I was given a syntocin drip as my waters had broken 10 days before ds was due and, despite pessaries, I hadn't started into labour 42 hours later (at St Michaels, Leese).

The contractions kicked in after about 20-30 mins. 2 hours later I was 10cm and gave birth after 20 mins. Had gas and air for pain relief and didn't need any stitches. I'm preparing for a homebirth so I am hoping that things will be swift again but don't want to have any unreasonable expectations. Mainly as in Sweden, you are really restricted by the pain relief you can have at home. No gas and air or pethidine, you have to go to hospital for that.

Incidentally, when my mother had her first child her waters broke and 48 hours later she went into a quick labour with my brother.

I would love your feedback. Thanks.

Can I just put a question to the on-line clinic also . My waters broke in my first labour an hour or so before the contractions started. I am now 35 weeks pg with number two and wondered if it was likely that my second labour would start the same way? I realise that no two pregnancies or births are alike but did wonder if waters breaking could be a particular thing that happens with certain women. The reason I ask is that I am nervous of missing the start of labour as I carry Group Strep B and have to get to the hospital for IV antibiotics which I believe should be administered four hours before the birth. I have read so much about second labours being quicker that I am feeling a little worried about leaving it too late to go in.

That's interesting lou33 - number one for me was 2 hours 20 and number two 1 hour exactly. We are hoping for a third so that makes it about 10 minutes!

My waters didn't break until an hour before she was born and I was well into the contractions then. I had to really concentrate on pushing to break them. I went from 2cm to 8cm in an hour. Reading your stories I am worried it will just pop out next time. Although the whole process was 6 hours and 2.5 from 8cm to dd's arrival.

MalmoMum,

I have some facts and figures for you that might be helpful. In 1996, the The Term Prelabour Rupture of Membranes (TERMPROM) Study studied 5041 women with prelabour membrane rupture at term. Women were randomly assignes to induction of labour with intravenous oxytocin, induction with vaginal prostin gel or expectant management for up to 4 days, with labour induced with either intravenous oxytocin or vaginal prostin gel if complications developed. There was no significant difference in the rate of infection or number of caesarean sections. The study did show that women preferred to be induced than wait 4 days.

The study quoted previous evidence that stated if labour is not induced, over 60% of women will labour spontaneously within24 hours and over 95% begin labour within 72 hours. The average interval in the study for women awaiting spontaneous labour was 32.6 hours, the longest being 106.5hours.

If your waters do break before labour and your pregnancy is healthy and you do not develop a temperature, there is no reason to assume that you will not eventually go into labour yourself at home. It might be that you will get fed up waiting!

Demented, as you rightly said no two labours are the same so it cannot be predicted whether your waters will break or not. I can understand that you are worried about getting the timing right for your antibiotics but yyour hospital will have a policy for babies who are born within the 4 hour interval. We take swabs and a gastric aspirate ( fluid from the baby's stomach) and send it to the laboratory. If group B strep is identified the baby is started on antibiotics. I have seen a number of babies who have delivered themselves before their mums had their antibiotics and they have been fine.

Hope that helps you both. Hope it made sense because I am just off the night shift

bluebear, don't have any evidence other than my own experience. Had long first labour, over 20 hours with a failed ventouse and then very protracted forceps delivery. Baby stuck in birth canal for over 2 hours. Second time under 2 hours and only 22 mins in second stage. Hope it might be the same for you.

Bells,I dont know about you but I feel really fortunate that I didn't have to be in labour for hours !

Did you get to hospital with either baby? My first and third were born at home by accident, and my second was delivered 3 mins after getting to hospital. Number 4 they took me in early so I didn't deliver unattended, which was just as well by the speed he came!

Got to hospital both times (as only live a 3 minute drive away). I am eternally grateful for my speedy deliveries - 2nd time around was an especially wonderful experience. Am sorely tempted by the idea of a home delivery if we are fortunate enough to have a third but suspect I will bottle out of it.

A question for Mears actually : immediately after I had my daughter I felt absolutely fantastic and would have loved to have gone home (it was 10pm). The midwife did however insist I stay in overnight. After 10 hours in an overcrowded ward with non-flushing loos, a lot of noise and consequently no sleep, I felt absolutely dreadful. I just would have loved to have spent that first night with my husband. What would happen if you just insisted on going home? Is it possible to come back for the peadiatrician's check at a fixed time?

Bells2, I don't know what the rules and regs are about leaving hospital, but here's what happened to me. I went in for my 2nd delivery on a 6-hour turnaround (i.e. if you have the baby and everything is OK then you can go home 6 hours after the birth). Dd was born at 2.30 a.m., but for some reason we got caught up with paediatricians changing shifts and didn't manage to catch the on duty paed before he/she started their ward rounds. My community midwife had told me not to let them send me down to the ward - she said that if you're blocking a delivery room you're more likely to get seen quickly, whereas once you're down on the ward you're no longer a priority. We got very fed up with waiting, and in the end the hospital rang my GP who agreed to come and see dd as soon as we got home. So we signed everything, then just as we were about to walk out the paed turned up after all and checked dd over. We finally got away about 10.30 a.m. - not quite 6 hrs but not too bad, and no suffering hospital food other than some toast for breakfast.

I had a homebirth (first baby) after encouragement from community midwives and it was great. I had pethedine and gas/air and went from 3cm to 10cm in 5 hours with 15 mins pushing. I'm convinced it went quickly because I was so relaxed at home. Also great not to be in hospital afterwards (own bath, own bed etc). If you think you might like a homebirth but are worried about not coping I suggest you seriously consider it if you are within a 15 min drive of the hospital. You can change your mind at any time and the whole experience is so much more personal and relaxed with the dedicted attention of the midwife. Of course any sign of a problem and you will be advised to transfer to hospital anyway and apparently you are No 1 priority for the ambulances if the need arises.

Bells2 - you could insist on going home and your GP could do the baby examination, just like Azzie said. You can be discharged from labour suite in our area but each hospital has it's own policy. If labour ward is extremely busy you might be asked to go to the postnatal ward for a few hours prior to going home. This is not essential but some hospitals may ask you to 'sign yourself out' so as to absolve them of any resonsibility should you have any problems.

Once you are home the baby is the GPs responsibility so that is why it is not necessary to make an appointment to see a paediatrician. Next time I would state in advance that you want to go home ASAP from labour suite - there is no necessity to stay even 6 hours.

Malmomum - personally don't think your expectations are unreasonable. OK, so you won't have syntocinon at home, but you will have the relaxed environment which counts greatly towards a speedy delivery! As has been said again and again, not two labours are the same, but having laboured quickly before, I would suspect you would do so again - sounds to me like youe home delivery is a good idea! who's your community midwife Malmomum? Wander if I cover your area..
Demented - just to echo Mears, wouldn't expect your waters to break as they did before necessarily - doesn't really have much to do with what happened before, or what type of labourer you are - more luck! Out of interest, and I'm sure Mears would agree with this, when I have cause to 'break' someones waters, some tear really easily, and others are like old bits of leather - really tough! Not sure why.
Bells2 - have you heard the old adage - sometimes third babies take a bit longer?! Not to put the mockers on anything, but perversely sometimes, despite second babies swift arrivals, third babies really mess around! Hopefully not the case for you - let us know! We could start our own randomised control trial....
Oh, and Demented, just to put your mind at rest a bit - don't get too worried about the Strep B thingy - if the hospital knows you are a carrier, they will do careful observations on your new arrival. Just because you carry Strep B (and 10% of us do - most unknowingly - me included), the chances of it being passed to the baby are minute. The liklihood is you won't get four hours of IV antibiotics prior to delivery, but then most women on second babies don't - it's just another (unrealistic) 'ideal'. Many women deliver and go home without ever being aware they carry Strep B.

Thanks Mears, poor you just off the nightshift and ready to start again on Mumsnet . What you have said has helped put my mind at ease. It is something I feel fine about most of the time and then suddenly get very anxious about it especially when read some people's experiences. Thanks again you have helped me put the Strep B to the back of my mind again where it belongs.

Thanks leese, just read your post. Hoping not to be like leather if my waters need to be broken! I always get the feeling I would rather not know about the Strep B as I realise even if you have it it doesn't necessarily mean that anything terrible is going to happen but then on the otherhand at least if I know if have the chance of doing something about it. I would love to get home quickly this time and my midwife has advised that I just keep telling them this at the hospital and have it written on my birth plan (been refused a home birth but feel this would be the next best thing) but I have also read that as I carry Strep B they may want to observe the baby for a couple of days, do you know if this is likely?

Thanks you all so much for your feedback. Leese, I'm now in southern Sweden so possibly a little out of your regular scope. I was really pleased with my first delivery and how it all went so, naturally, I want the same quick delivery without a drip too.

Am I right in supposing that I stand as good a chance of having a swift birth this time around without the aid of the syntocin? I'm just trying to prepare myself as I am now starting to worry that I am too relaxed and maybe in for a surprise.

Thanks for the figures, Mears. There is not much pressure to induce in Sweden and they will leave you for 3-4 days without interference if your membranes rupture at full term and you have no other symptoms. I was not a willing case for induction last time (we were moving house).

Thanks again.

Thanks for the comments Leese and Mears. Have certainly heard in the past that number 3 can be a bit more tricky. Interesting about the discharge from hospital information. I have utmost admiration for midwives and both times have been reluctant to cause any problems/ extra work for them by insisting on leaving soon after the birth. If there is a next time though, I will certainly make it clear from the outset.

LKM, it's not the coping aspect that would stop me having a homebirth as I didn't have any pain relief with the first two. It is just the nagging fear of something going wrong at the last minute and the worry that the 20 minute or so delay in getting to hospital could make the difference. No doubt its irrational but I'm just not sure I could overcome it

On a slightly different note, can the fact that no 2 is bigger make a difference to difficulty /length of labour? I had a fairly swift labour with no 1 (5ish hours)but he was a big baby with a v big head (8lb10 - all of him not just the head!) No 2 looks bigger again and am feeling a but worried...

Natt, Often subsequent babies are bigger and labour progresses more quickly. Second time around you look and feel bigger sometimes just because abdominal muscle tone isn't so good abd you get a surprise when baby number 2 is actually samller. My first was 8lb 1oz and my second was 8lb and I thought I was huge